WILLARD I AGNEW - Athletic Trainer License in Indiana | # 096002014

WILLARD I AGNEW

Business Entity

INACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002014

License Status

INACTIVE

Business

N

First Name

WILLARD

Middle

I

Last Name

AGNEW

Business Name

WILLARD I AGNEW

Original Issue Date

11/03/2004

Effective Date

06/01/2006

Expiration Date

05/31/2008

State

IN

Ever Disciplined

N

LastModifiedDate

03/07/2008